Kenat, I believe that the runaway costs associated with medical care in the United States today is a direct result of the practices established by the insurance companies. This is an area which received surprisingly little (or no) attention regarding reform in the health care legislation that was passed by Congress and signed into law by Obama. How these insurance companies set policy, handle claims, and establish charges for different types of exams and medical care, as well as the exhorbitant salaries that many of their employees enjoy are a very big part of the problem. The sky high premiums they charge for malpractice insurance, which not surprisingly was brought about as a direct result of lawsuits, is also a significant factor in these runaway healthcare costs. The wages that doctors earn I am sure does play a part in this, but I believe that it is secondary to the ones that I mentioned above. In my opinion, limiting the number of doctors that are enrolled in medical programs each year does not have the adverse financial impact on the healthcare system that you assumed.
And no, I would not expect the same issues to be mirrored in engineering if enrollment in those programs is capped. Runaway engineering costs are extremely unlikely due to the number of choices that clients have. If they are not happy with one engineering firm or consultant, they can go to another. Just as if you are not happy with your doctor and want a second opinion, you can consult another doctor. The difference is that doctors tend not to have a bidding war regarding prices because patients want the best medical care that their insurance companies will allow them to afford. They don't concern themselves with cost in many cases, but quality of care. In engineering it should be similar - clients should want the best engineering services that they can afford. But engineering firms will often slit their own throats in a race to the bottom on pricing. This is where the difference lies, and it is all too common in industry today.
Medical outsourcing is a reality these days - MRI scans are now electronically sent overseas on a routine basis and evaluated by medical professionals in foreign countries. Insurance companies provide incentives for this because it is far less expensive to have an overseas doctor with similar training but lower salary requirements interpret the results. The insurance companies and medical institutions save money if this is done, but somehow this savings does not get passed on to us in terms of lower premiums or reduced costs. So where does this saved money go? In the pocket of the medical industry - problem. By the way, would you allow yourself to be examined by a medical doctor or operated on by a surgeon who was not board certified? If the answer is yes, then why would someone go to an engineer for services if that engineer was not certified in a similar sense (read PE)?
Snorgy, I think that the mix of abilities in today's students are the same as they have always been, but that the motivations and expectations these students have on the whole are not. They seem to have a general sense of entitlement, that things will automatically be made easier for them if they encounter what they would consider to be an issue. The text books are as good as they ever were, and in some cases are substantially better than what we used. But the expectations placed on the instructors to pass a larger percentage of the students even if they underperform, and the manner in which the educational system has been motivated by "no child left behind" and similar legislation, has hampered our educational progress. It's not that students are less capable - they aren't. It's that the bar has been considerably lowered in terms of our expectations for them.
I believe that the way for us to raise our profession up is to take the reins. We shouldn't sit by and complain about how we are underpaid, unappreciated, or generally disregarded by society as Dilbert-like eggheads. We should do something about it!
Maui
